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Author Spotlight: Overcoming Anti-VEGF Resistance Through Advanced Vascular Morphology Assessment in Choroidal Neovascularization
Published on: August 11, 2023
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Choroidal Changes After Anti-VEGF Therapy in AMD Eyes With Different Types of Macular Neovascularization Using
Mengxi Shen1, Hao Zhou2, Jie Lu2
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States.
Investigative Ophthalmology & Visual Science
|October 11, 2023
Summary
Choroidal thickness and vascularity increase with exudative age-related macular degeneration (AMD) onset and decrease after anti-VEGF therapy. These changes occur regardless of macular neovascularization (MNV) origin.
Area of Science:
- Ophthalmology
- Medical Imaging
- Vascular Biology
Background:
- Exudative age-related macular degeneration (AMD) involves abnormal blood vessel growth.
- Macular neovascularization (MNV) can originate from the choroid (Type 1/2) or retina (Type 3).
- Understanding choroidal changes in AMD is crucial for treatment strategies.
Purpose of the Study:
- To investigate choroidal changes before and after anti-VEGF therapy in exudative AMD.
- To compare these changes between MNV originating from the choroid versus the retina.
Main Methods:
- Swept-source optical coherence tomography angiography (SS-OCTA) was used in treatment-naïve AMD patients.
- Choroidal thickness and choroidal vascularity index (CVI) were measured in fovea-centered circles.
- Measurements were taken before, during exudation onset, and after anti-VEGF treatment.
Main Results:
- Choroidal thickness and CVI increased from pretreatment to exudation onset (P ≤ 0.03).
- Choroidal thickness and CVI decreased significantly after anti-VEGF therapy (P < 0.001).
- No significant differences in choroidal changes were found between Type 1/2 MNV and Type 3 MNV.
Conclusions:
- Choroidal thickness and vascularity fluctuate with exudation and anti-VEGF treatment in AMD.
- These choroidal changes appear to be a response to the proangiogenic environment and subsequent treatment.
- The origin of MNV (choroidal vs. retinal) did not significantly alter these observed choroidal dynamics.
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